People affected by sex addiction can have symptoms related to sexual thoughts, fantasies or behaviors generally viewed as acceptable or normal in a non-addiction context. However, they can also have symptoms related to thoughts, fantasies or behaviors that violate social norms or specific laws. In a study review published in late 2014 in the journal Sexual Medicine Reviews, researchers from Germany’s University Medical Center Hamburg-Eppendorf used an analysis of 14 previous studies to help determine how well current psychotherapy-based options for sex addiction treatment address symptoms related to socially acceptable thoughts, fantasies and behaviors.

Sex Addiction and Paraphilic Sex Addiction

All individuals dealing with sex addiction have recurring thoughts, daydreams and/or behaviors that significantly interfere with their ability to maintain a stable daily routine or experience a sense of emotional/psychological well-being. In the U.S., doctors have no single standard method for diagnosing the condition. However, commonly identified sex addiction symptoms include such things as a recurring inability to exert control over sexual behaviors or sexual thinking/fantasizing, recurring use of sexual behaviors or thinking/fantasizing as an escape from personal problems or unwanted mental states, recurring participation in sexual behaviors or thinking/fantasizing in situations that endanger oneself or others and prioritization of sexual behaviors or sexual thinking/fantasizing over major daily duties or responsibilities. Specific possible real-world contexts for sex addiction include pornography use, involvement in Internet-based cybersex, visits to strip clubs or other sex-centric establishments, phone sex and direct encounters with other people.

Manifestations of sex addiction-related behavior and thought/fantasy that violate laws or social norms in many or all circumstances include sadism, masochism, exhibitionism, voyeurism, fetishism and pedophilia. The American Psychiatric Association maintains a category of mental illness called paraphilic disorders for people whose involvement in these activities causes harm to the individual or to others. Specific illnesses designated as paraphilic disorders include sexual sadism disorder, sexual masochism disorder, exhibitionistic disorder, voyeuristic disorder, fetishistic disorder, pedophilic disorder, frotteuristic disorder and transvestic disorder. Most people affected by sex addiction do not have any of these conditions.

Sex Addiction Treatment

Sex addiction is a multifaceted condition, and any given individual may need help with a specific grouping of symptoms that don’t appear in every addicted person. Aspects of addiction that may need to be addressed include an impaired ability to function in important public or private environments, loss of the ability to cope appropriately with “down” or negative mental states that motivate addictive sexual behavior or thought/fantasy, loss of the ability to cope appropriately with stressful exterior circumstances that motivate addictive behavior or thought/fantasy, loss of the ability to limit involvement in sexual behavior or thought/fantasy and involvement in sexual behaviors, thoughts or fantasies that pose a danger to self or others. Forms of psychotherapy used in sex addiction treatment include a behavior-oriented approach called cognitive behavioral therapy and a self-understanding-oriented approach called psychodynamic psychotherapy. Doctors may also adapt a number of medications for use in sex addiction treatment, including mood stabilizers, sex hormone-reducing medications, antidepressants and the alcoholism medication naltrexone.

How Comprehensive Are Psychotherapeutic Treatments?

In the study review published in Sexual Medicine Reviews, the University Medical Center Hamburg-Eppendorf researchers analyzed the results of modern studies that have focused on the real-world results of psychotherapy-based sex addiction treatment for people not affected by a paraphilic disorder. The researchers specifically focused on studies that included detailed results from successful treatment approaches. Each of the 14 studies under consideration looked at outcomes associated with at least one of the symptoms commonly found in individuals affected by sex addiction.

After completing their analysis, the researchers concluded that the included studies generally demonstrate psychotherapy’s usefulness as a treatment for a range of sex addiction symptoms, including a loss of self-control, an inability to cope with “down” or negative states of mind, an inability to cope with stressful life circumstances and an impaired ability to function normally at home, at work or in other private or public environments. The only sex addiction symptoms not targeted and addressed were physical harm to oneself or other people and emotional harm to oneself or other people.

The study’s authors note that, while psychotherapeutic treatments work for many individuals dealing with sex addiction, doctors and researchers are frequently unable to explain why they work. They urge future researchers to help clarify the mechanisms of treatment, and thereby improve the accuracy and usefulness of provided care.

*Photographs on this website (hereafter known as “Content”) use models/actors. The Content is being used for illustrative purposes only. All trademarks or registered trademarks are the property of their respective owners.